Report (2) Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: 1/1(S1-790 - 00 3 q 7 Jurisdiction:
Site Address: j 7 q �, \ c2 I ( f
t
Subdivision/Lot#: ro _- d r
and/or
Map and Tax Lot#: ( j j I
By my signature below, I certify that a minimum of fifty(50)percent of the permanently
installed lighting fixtures in the above mentioned building have been installed with compact or
linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt.
(Oregon Residential Specialty Code N1107.2)1
Signature: Date: q-99-PCoo
Owner/General Contractor/Authorized Agent
Print Name: �)-o\0-e
1 ORSC Section N1107.2.High-efficiency interior lighting systems. A minimum of fifty(50)percent o the
permanently installed lighting fixtures shall be installed with compact or linear fluorescent,or a lighting source that
has a minimum efficacy of 40 lumens per input watt. Screw-in compact fluorescent lamps comply with this
requirement.
The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the
permanently installed lighting fixtures are compact or linear fluorescent,or a minimum efficacy of 40 lumens per
input watt.
I:\Building\Forms\RES-HighEfficiencyLighting.doc 07/01/08
Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, `V0 k-Lovz-tr , am the general contractor or the owner-builder
at the following address:
Site Address: l V S7c.1 "
City: 1
TITr�
Permit#: S 9 0 ( g- 00.3(47
Subdivision/Lot#: \LTh J321 1
and/or '�
Map and Tax Lot#:
To conform with the 2014 Oregon Residential Specialty Code (ORSC), Section R408.1
Ventilation. I am notifying the building official that I have installed the Moisture Barrier as per
Requirement in ORSC Section 408.1 and have taken the following steps to meet this code
requirement:
The ground surface of the under-floor space is covered with 6-mil black polyethylene
sheeting with
Joints lapped 12"at seams and
r7l Extending up the foundation walls 12".
Signature: 1p e` _ Date: 9-p - 0 6)
General Contractor or Owner-Builder
I:'Building\Form\RES-MoistureBarrier.doc 09/13/2016
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, 6%ge40,„02,r-
, am the general contractor or the owner-builder
at the following address:
Site Address: (05 7 c.. S � `It.),J
City r(� t/
Permit#:
6& 9ol, —o03 - 7
Subdivision/Lot#: ' J ur
rpq.a__
and/or
Map and Tax Lot#: (r 1 I
To conform with the 2008 Oregon Residential Specialty Code(ORSC), Section R318.2 and
OAR 918-480-0140, I am notifying the building official that I am aware of the moisture content
Requirement of ORSC Section R318.2 and have taken steps to meet this code requirement.
[Section R318.2 is provided for reference].
R318.2 Moisture Content: Prior to the installation of interior finishes,the building
official shall be notified in writing by the general contractor that all moisture-sensitive
wood framing members used in construction have a moisture content of not more than 19
percent by dry weight of dry framing members.
Signature: �/ w'�' Date: 6) - a -d 0 a®
General Contractor or Owner-Builder
I:\Building\Form\RES-MoistureSensitiveWood.doc 09/25/08
Form 640S 2017
Completion Certification—Site Inspection
New Homes Program—Single Family FnerryTarust
of Oregon
To be completed by Verifier
CLEAResult is a Program Management Contractor for Energy Trust of Oregon,Inc.
Payment Information
Incentive Payee Company Name Polygon Northwest-WA Its this payment redirected?. INo
Builder or Company: Polygon Northwest-WA Redirect to Name:
Verifier Payee Company Name. Performance Insulation and Energy Redirect Payee Corn
Affordable Housing No
Solar Ready Builder Incentive. No Solar ReadyVerifier Inc4No
Site Information
Development. River Terracee 2 JLot 1141 Axis ID- I 'REM/Rate®ID.
Address: ,,,Z,ZML:kS,g+, ,,n.
Street Line 2 Multi-Family INo City. Tigard State: OR Zip. 97223
Total conditioned area(sq.ft.): 3,248 House Volume: I 29,029 Housing Type: Detached single family
Number of Stories. 12 Number of Bedrooms. 4 Foundation Type: Crawlspace
Electric Provider. _Portland General Electric Gas Provider: NW Natural Gas
Solar installed None Solar Installer Name/Company:
Blue shaded fields are required for EPS sheet
Verification Type Actual Model Equipment Details&Notes
Slab Perimeter Insulation R- 0.0 Slab Under Insulation R-
Framed Floor R- 30.0 Secondary Framed Floor R- 59.0
Insulation
Above Grade Wall Insulation R- 23.0 Below Grade Wall Insulation R-
Flat Ceiling Insulation R- 49.0 Vaulted Ceiling Insulation R-
Windows Windows U- 0.3 SHGC.I0.3 Total window area: 1510
Cooling Air Conditioning SEER. 13 Model#: 113ANA042-C
Primary Heating System Details AFUE: 92.1 Brand Bryant
Type: Gas Furnace HSPF: Model#: 912SD48080E17
Heating Fuel: Gas SEER:
Primary Heat Comment: COP:
Source -----
Location: Conditioned A Outdoor Unit(for heat pumps)
ECM: No Model#. I
AHRI Certificate:7126235 #of Systems 11
Gallons. I Brand: AOSmith
Water Heater Type EF. I Model#: HPTU-80N 130
Water Heating Fuel Location: 'Garage or ope
Ducts and Duct Location 'Conditioned %ducts inside , Duct Leakage(CFM)@ 50Pa: 1136
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 2.66 I
Ventilation Type HRV/ERV Model:
Ventilation
Supply Side-Air Cycler Airflow measured or why untestable? (Roof Termination
Appliances
Refrigerator kWh/yr Model.
ENERGY STAR Diswasher kWh/yr 268 Model. FGID2466"`A
Percent High Efficacy Interior Lighting(%) 100% Thermostat
Showerhead 1.5 GPH I Showerwand 1.5 GPH I Showerhead 1.6 GPH I IShowerhead 1.75 GPH I
Notes: